External-Beam Radiation Therapy May Have “Neglected” Side Effects, Study Suggests

Men who undergo external-beam radiation therapy (EBRT) for prostate cancer may develop a number of side effects, most notably erectile dysfunction (ED) and urinary problems. However, lesser-known side effects, such as issues with orgasm, need attention as well, according to new research.

The retrospective study discussed the prevalence of “neglected” side effects, including altered perception of orgasm, orgasm-associated pain, anejaculation, urinary incontinence during sex, self-perceived altered penile morphology, and sensory disturbances in the penis after EBRT.

One hundred nine men who had undergone EBRT at the same institution responded to a questionnaire developed by the research team. The men ranged in age from 57 to 81 years with a median age of 71. All had received a radiation dose of 78 Gy and underwent androgen deprivation therapy as warranted by their personal situation. All of the men were sexually active. Prostate cancer treatment had occurred three months to five years before the study.

Decreased orgasm intensity was the most common of the investigated side effects, reported by 44% of the men. Forty percent said it took them longer to reach orgasm, and 15% had pain with orgasm. Almost a quarter of the men were unable to reach orgasm at all.

Forty-two percent believed that their penis had lost more than one centimeter of length and 27% experienced decreased sensitivity. Twelve percent had a curvature in the penis.

Few of the men (4%) said they had had episodes of incontinence during sexual activity.

The authors recommended further research on the prevention and treatment of such side effects, as well as prospective studies comparing the side effects of EBRT and radical prostatectomy.

“All patients electing treatment for prostate cancer should, in addition to ED and urinary incontinence, be queried routinely on orgasmic dysfunction, changes in penile morphology, and sensory disturbance as part of follow-up,” they added.

The study was published online in February in the Journal of Sexual Medicine.